MEDICARE: PARAMOUNT URGENT CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1477014744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAMOUNT URGENT CARE INC

Provider Business Mailing Address
First Line	:	805 EAST CR 466
Second Line	:
City	:	LADY LAKE
State	:	FL
Zip	:	32159-4205
Country	:	US
Telephone Number	:	352-674-9218
Fax Number	:	352-259-6069

Provider Business Practice Location Address
First Line	:	5845 WINTER GARDEN VINELAND RD STE 120
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-6124
Country	:	US
Telephone Number	:	407-203-1682
Fax Number	:	407-203-1737

Authorized Official
Title or Position	:	CO-OWNER
Name	:	ADRIAN EASTERLING
Credential	:
Telephone Number	:	352-674-9218

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	03/28/2019

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